Acute upper GI bleeding: good night, sleep tight, endoscopy can wait until morning light.

Gastrointestinal hemorrhage is the leading cause of hospitalization in gastroenterology (Gastroenterology 2019;156:254-272). Prognostic scoring systems for acute upper GI bleeding (AUGIB), such as the Glasgow-Blatchford score (GBS) or Rockall score, can help predict which patients require intervention (Lancet 2000;356:1318-21, Gut 1996;38:316-21). Evidence does not strongly favor one particular index, but the GBS has good sensitivity for detecting patients at high risk of re-bleeding and death. Nevertheless mortality in AUGIB remains essentially unchanged over the past two decades. Despite advances in endoscopic and pharmacological therapies, case fatality is approximately 5-10% globally (BMJ 1995;311:222-6). Historically, a major focus to improve outcome has centered on performing timely endoscopy to achieve early hemostatic control.

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